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Home My WebLink AboutEAGLE RIVER VALLEY RANCHETTES LT 25AEogle River' Vail Y Ranchettes Lot 2§A #050- 223- ! 7 e Municipality or Anchorage :.'.3~ Development Semices Department -'~ : Building Safe~ DMs~on On-Site Water and Wast~ter Pr~mm. 4700 S. Bragaw St. P.O. Box J~50 ~orage.~ 99519-6650 Page ~.d.an~o~ge.ak.~s (~ ON-SITE WASTEWATER DISPOSAL SYSTEM AflDIOR WELL INSPECTION REPORT Permit Number: d~O~~ PID Numbe~ "--: ~;~ ~,S&~;~ WasiewaterSystem: DNew ~Upgmde I~O~e~y Sr~Poad F~ le~;aer.~5 ~7-E~I AaSORPTION FIELD Welt: D New ~ Upgrade e.~ v~: ~ ~~ TANK SEPARATION DISTANCES ~se~c ~ Holding ~ S.T,E.P, ~ Othe~ ~ Septic ~so~tion L~ Holding =ub~ah · . Tank F~ld Slat,onTank ,~. ~, n~ I ~n ~ I~- ~=w.. iOQV J~'+ ~i LIFT STATION "~': ~ ~C~-S ~ ~~-- BENCH MARK ,, E~tamp .. .. No Dates: t .. Devetopmen[ So.Ices Depadmen~ Approval P£R,~? NO SW020204 P~C£ 2 OF ,.3 D ........ Muoi_cip. 9_ti~. y_o. F I:HAN/Mi:N/ OI- HI:AL/H ANL) HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D Box 196650,Anchorage, At~sk~ 99519-6650, Tetephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT L£CAL LOT 25A, EAGLE RIVER VALLEY RANCHETTES P.LD. NO. 050-223-17 / / LOT 33B LOT 33C / / TWENTY GRAND AVE. EXISTING LOT 25B LOT 26A 3 BDEM HOUSE 10' UTILITY [ASEMENT ScA~: PERMIT NO. SW020204 PACE 3 OF 3 Municip. oU't oF An~h.q.pgg.e. DEPARTMENT OF HE~,~.THAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 $Anchoroge, Alosko 99519-6650e Telephone= 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 25A, EAGLE RIVER VALLEY RANCHETTES P.I.D. NO. 050-225-17 ST1 ST2 j 97.4' FINAL _..,/I EXISTING 1000 93'4" I-' GALLON '" I''93'2' J SEPTIC TANK J CO1 =96.8' A B FCO 20.0' 19.5' ST1 30.0' 17.5' ST2 35.5' 21.5' DBL1 37.5' 23.0' DBL2 39.0' 23.5' C01 48.0' 37.0' MT1 51.5' 38.0' C02 105.0' 70.5' k4T2 105.0' 70.0' -C02 =94.5' FINALGRA~E/ ~ ~2" INSULATION '. MT1 = 87.3' J MT2=87.3' WATER FOUND ® 80.8' 79.8' B.O.H. Municipality of Anchorage Development Services Department Building Sa~e~y {~b~cn On-Site Water a~d Was,~v, ater Pr~ram 4700 South Bragaw SL P.O. Box 1.e6650 N~d'~3~e, AK 99519-6650 Soils Log - Percolation Test Pedon~edFor: 'K~t'~'f'/ /v~/rC~t~,~( Dete. Perfcxmed: 7/3/0 ~ Legal Descrip[ion: ~,-0~' ~ ~ ~ ~,,AC.b~. ,~IV~,~ V~"t'~Y R'~ct~;'r~ J Township. R=nge. Se~on:, .4 2- 3- 4- 7- 8- 9. 10- 11- 12- Plan WAS GROUND WATER ENCOUNTERED? IF YES, AT ?~T DEP~ Dep~ toWater A~er &Tonltodng? Date: 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS Reading Date Gross Time Net Time Depth t~ Water Net Drop i 7 /5/o ~.0 '"- .~- ,I~ " -- 30 50 ,~,,~ 7~4" O '4 '" 3o - ~%" - I I 6o - ~ y~" - ~ o 30 ~,~ ~ ~ I '/~" PERCCLATIO~RATE, c~ O (rr~r~tes.'.-~) PERCH(~.EDIA,~.IETER ~" TEST RUN B :-'~VEEN ~'/ FT AND ~ FT PERFORMED IN ACCORDANCE WITH ALL STATE .A.ND &IUN,ClPAL GUIDEUNES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 EXC, Tb/EF--O ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 02, 2002 Expiration Date: Jul 02, 2003 Permit Number: SW020204 Parcel ID: 050-223-17 Legal Description: EAGLE RIVER VALLEY RANCH~- 1 lES LT 25A Design Engineer: 0003 S & S Engineering Site Address: 018610 TWENTY GRAND RD Owner Name: Keith Muschinske Lot Size: 17955 SQ. FT. Owner Address: 18610 TWENTY GRAND ROAD Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER, AK 99577-8331 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be tn accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: "~'~2 ~ Date: "7 /,3--/~' 'z'-- Municipality of Anchorage George I; Wuerch, Mayor Btfilding S,'ffcty Dirlsion P.O. I'h>x 10C~13.50 * -'!-700 $. Bragaw Street ,'mchomgc, Alaska 00519-C'C~0 · (007) 3-'t3-8801 httl~://wwxv.cl.anchon~gc.ak.us 7/2/2002 Bob Cowan P.E. S&S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for Eagle River Valley Ranchettes Lot 25A Waiver Request #WR020037 Parcel ID #050-223-17 Dear Mr. Cowan: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site xvastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Waslewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O 5'0 - ~-~- '5 - I '7 Permit Number SWOZO~¢... Property owner(s) ~.~ E. V't ~ ~",~ Lt 5 C~ I ~ 5 KG Mailing address (1) [ ~ I,~.O "~LI~'~'V ~.P.A ~ Mailing address (2) ¢.a~XL K,~. ~ Legal description (Lot, Block & Sub'd.) ~ ~5 ~ Day phone Zip Code Legal description (Section. Township & Range) Lot Size I~ i ct ~''~ '-A-c~~ Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only [] Water Storage [] THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jacuzzi . Water Softemng Unit I cedify that the above Information Is correct. I fudher certify that this application Is being made for a Single Family Dwelling and is In accordance with applicable Municipal Codes. (Signature of properly owner or authorized agent) Permit Fees: fO0. ~-;"/[,)-O (~,,,~'~') Waiver Fees: ~ Date of Payment: {~/o~ ~'/o z.- Date ol' Payment: Receipt Number: (Rev, 12/00) Receipt Number: 1703'1 E~tc ~,ver Loop RC~ No. 2G4 ~agle R;ver, Alaska 99571~ LVO. ~ o ROBERT C. COWAN, P.E. CML F...NGINEERS (907) 694-2979 FAX (907) 694-12'11 June 26, 2002 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 25A, Eagle River Valley Ranchettes Subdivision It is requested that you issue a permit to upgrade a septic system to serve the existing three bedroom dwelling on the referenced properOd. A lot line waiver of zero feet is also requested for the west lot line of the property to the proposed trench. One test hole was excavated and a percolation test was performed on 6/20/02. The approximate location of the test hole is located on the attached site plan. Ground water was monitored and after seven days the hole was dry as shown on the attached soils logs. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or .drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. Ifyou require additional information, please contact us. Sincerely, Robert C. Cowan~ P.E. RCC/jhm Enclosure 17034 NORTH EAGLE RIVER LOOP * SUITE 20,4 ~ EAGLE RIVER, ALASKA 99577 ~ LOT 25A. EAGLE RIVER VALLEY RANCIIETTES ) ~,~'~ \'~'$ ~'. DESIGN CRITERIA: ~.~u.~. g~. o. ~c~o~c.~e~vs ~r~ll~ 3 BDR~ = 450 GPD SHO~ O~ THIS SITE P~ ARE ~S SltOWN ON .'..,~,[.~/:.~.~....~ ~ILLIA~ D. FLEMINC 450/0.6 = 750 SQ.~. REQ'D, IT IS THE RESPONSIBILTY OF THE CONT~OR TO VER'~ ~SEMENTS. REQUIRED SEPA~TION TRENCII CRITERIA: DI~A~C[S. AND PROPE~ ~NES PRIOR TO]1~% CE-~O{ (AOL[ mv;m t~P mOAO 5.5' EFFE~IVE ~ / O~TAIN UIILIIY LOCATES PRIOR TO ANY EXCAVATION WORK, /// "/ ~/ TWENTY GRAND AVE. // ' " " ~o~ IX{StING I000 G*LLON EXISTING ~,,~ ,.~.-- 2 5 B 26A (v~.,r,ru q{o/oz) 3 BDRM EX}STING TR[NCH ~ ~ HOUSE ~ EXISTING / To BE ABANDONED{ ~ . ,. /WATERUNI ' ' ~i '~,L rc ....... :~-,' m eZ~--~. ---[~,~-~ ,- / EXISTING LOt L, NE waiver ~ ' fi~l~ , ~:~:~ BE cO.PLEtELY .... REQU[ST[D CO "' A M~--~ ABANDONED 10' Ulil [stol MiN. 10' 10 Util [stat I -P[RCOLATION TEST -OLO CRI~ (TO BI · ..,.~ o, ~ 25C ..o.,. ~,.ov~. ALL PORTIONS OF' SYSTEM26C [XCAVanON lOX COVER REQU{RE INSU~TION. / / / / / / LOT 25A, J.tI.M. DESIGN CRITERIA: ~ ~ORM = 450 cpo SOILS = 0.6 CPD/SQ.FT. ~so/o.~ ~ ?~o SQ.rr. ~;Q'D. TRENCil CRITERIA: 8-1/2' D£gP ~' ~IDE 6~' 26A EAGLE RIVER R.C.C. EXISTING 1000 GALLON SEPTIC TANK (VERIFIED 6120/02) EXISTING TO BE ABANDONED LOT LINE REQUESTED MT 10' Util Esmt 10 yUfil Esmt VALLEY RANCIIETTES S/O .?~'<~[~)'~.~'~'x~h, I .,~%..'~'~ .............. ~'o ~ I Jo.,~: is.a,, ---'"..~' ~'".~-", I 7-2-02 2 OF 2 SHOWN ON THIS SITE P~N ARE ~ SI'OWN ON AN ~-BU{~T SURVEY D~WN BY: WILLIAM D. FLEMING ~'~ ROBERT~A~ TO VgRI~ ~S~B~, Rg~UlR~B SgPkRATIO~ CE-8801 DI~ANCES, *SD PROPER~ UNES PRIOR TO I. ~>,. ~.~ ~ I Mf MIN. 10' t- EXISTING 3 BDRM HOUSE /--EXISTING /WATERUNI -- /~[ (APPROX. __ g' '~ / ,~ LOCATION CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY £XCAVATION WORK, 25B ;TING TRENCHES TO BE COMPLETELY ABANDONED N 26C ALL PORTIONS OF SYSTEM WITII LESS TIIAN 3.5' OF COVER REQUIRE INSULATION. ATION TEST TO BE PERFORMED AT TIME OF / EXCAVATION~10% 25C OLD CRIB (TO BE EXCAVATED & BACKFILLED WITH M.O.A. APPROVED SAND) 250 Munlcipallty of Anchorage Development Services Department Building Safely Division On. SIle Water and Wastewater Program 4700 Sonlh Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 w~v.cf.anchoraqe akus (907) 343.7904 Soils Log - Percolation Test 5- 6- 7- 8- 9- 10- 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS Slope S[le Plan WAS GROUND WATER ENCOUNTERED7 IF YES. AT WHAT DEPTH? Depth lo Walee A~o~ Monllo/Ing? Dale: Reading Dale Gross Time Nel TimeDepth lo Water Nel Drop 0 o C" ~~ ~o ~o '~' ~," O. o 6y~" ~ PERCOLATION RATE ~ (.,,,-~ute-.,'ech! PERC tIOLE DIAMETER TEST RUN .ETwEE~'I ~ FT A~O ~ FT PERFORMED IN ACC-OI'~O~,NCE WITH ALL STATE AND MUNICIPAl. GUIDELINES IN EFFECT ON THIS DATE. DATE: r~OIL TEST ROBERT C. COWAN, P.E. CML ENGINEEP~ (907) 694-2979 FAX (907) 694-t2t ! ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS .REFERENCE: Lot 25A, Eagle River Valley Ranchettes Subdivision June 26, 2002 GENERAL: The scope oft,his project includes the verification of a 1000 gallon septic tank on 6/20/02, and installation of a new trench to serve the existing three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground · utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP* SUITE 204 * EAGLE R1VEF~ AL/~KA 99577 Page 2 Lot25A, Eagle River Valley Renchatte. $/D June 26, 2002 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. ofcover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than I0 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 2$A~Eagle River Valley Ranchettes 8/D June 26,2002 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. Thc following pipe materials arc approved for use in septic system installations in thc Municipality of Anchorage: Type of Pipe Perforated .Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM FSI0 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caul&r, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfleld gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: I~age 4 Lot 25A, Eagle River Valley Ranchette. $/D June 26, 2002 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any ~vay the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owners representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER g$ -l)'/ Municipality of Anchorage Page, I o! : DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ENF/~/OI~ PID Number: Address: ~ I No. of S~.rooms: ~"~-C~' ~-',v~'~, ,W/A. ~qC77 LEGAL DESCRIPTION Wastewater System: ~m New ~ Upgrade ABSORPTION FIELD ~ Deep Trench C] Shallow Trench tm Bed E'l Mound r-I Other SOil Rating: Total Depth from original grade; ~.G3PD/s<~ Itt. J~ ' Lot: Townahip: WELL: Yield: From C:~;,: Subdivieion: Oe~ffi to pipe bottom from original grade: IRange: I Soc,,o.: FIll added IbOve original grade: / Ft. New n Upgrade (~ve~ width: '2 .S~t. Total Depth: C.a se~ TO: Total absorption area: Gravel depth beneath pipe /"/ Ft. Gravel length: Number of lines: I DL~tance :~ I /0 Itt. Pipe matarlat: ~"'J'/O Ft. Ft. ~'(30 sQitt .4.r~-/s~ pJ'o~7e ~.v.c. SEPARATION DISTANCES ~eptic ~4/~ m Holding ~ S.T.E.P. Surface Water Lot Line Foundation Curtain Drain Remarks: LIFT STATION ufacturer. "Pump on" level at: Pump Make & Mode~ ~ I High water alarm at: BENCH MARK Location Ind Description: IAssumed Elevetlon: /00.(~0 Itt ENGINEEB~.SEAL .~, S & $ ENGINEERING Inspections performed by: ~ Ri.r, Al.~k. 9~$~' Dates. 1st t. -~2o*~t _ . 2nd ~, -z~-~ Department of Hea~l'L~tnd Huma'~.ervlces approval 'Permit No. SW940183 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:EAGLE RIVER VALLEY RANCHETTES, LOT 25~PiDNo.: 05022517 TWENTY GRAND ROAD A B FCO 19.5 20.0 CO1 .. tS.0- 30.0 C02 121.5 35.5 C03:37.5 80.0 I I CO4 '65.0 30.5 / i [ C05 39.0 29.0 /.,*" ~.~ ' ) CO6 70.0 39.0 /' ~.~ '. co? 48.0 40.5 /. ":"~"~ ' I C08 74.0 48.5 l ............. /, ', ' {' .'_ . ~. ~ u~l., ~5~._.3o~. I. ......... ~[ ~CJ' a ~;. 'a ' M~ 71,0 40.5 x cu,- ' x .' ~ ~ ~ ~ 7].o 47.o l H ........................................... ~ ............. ['~I~ING ......................................... ' ......... ~'~W"~CHES ................................ ? ................................ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940183 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:TAYLOR JAMES A & JEAN OWNER ADDRESS:lB610 TWENTY GRAND RD EAGLE RIVER, AK 99577 DATE ISSUED: 6/21/94 EXPIRATION DATE: 6/21/95 PARCEL ID:05022317 LEGAL DESCRIPTION: EAGLE RIVER VALLEY RANCHETTES LT 25A LOT SIZE: 17995 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DH/{S AT LEAST 2 NOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ~-XEiiX{EADER-PIPE-SERVING-THE-THREE.TRENCHES.MUST~E-INSTAL~ED TIN-SUCH 'AMANNER THAT DISTRIBUTION OF THE SEPTIC TANK EFFLUENT WILL"BE DIVIDED APPROXIMATELY'EQUALLY-BETWEEN-.THE ~THREE:SEGMENTS.OF_TH~TRENCH SYSTEM. - iSS D DATE DATE:~X~ June 06, 1994 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 REFERENCE: Eagle River Valley Ranchettes; Lot 25A ~TE PLANS SOP. TEST Request you issue a permit to upgrade the septic system serving the three bedrocm house on the referenced t~ut~erty. A test hole was excavated and percolation tests performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation, water~was-encounteredTat~15' and after seven day ground water monitoring water wasTagainlfound-'at~15'.'~. Attached is the proposed~bpgr~e-'desig~. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review/~ contact us. ~/RA LSU/jk ON S~E WASTE WATER DISPOSAL SYSTEM DES~N ./ 17034 NORTH EAGLE RIVER LOOP * SUITE 204 * EAGLE RIVER, ALASKA9957? GREATLAND REALTY 114110LdGL~HwV. Eagle giuer,' AK 99577 ~aV 9, 1994 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (9O7) 694-2979 FAX 694-1211 REFERENCE= Lot 25A; EagLe P~uer V~,~eV l~nch, ett~ SEWER & WATER ~SPECT]OH You~ a~t~on Z6 directed toward6 ou~ Zetter daXed October 29, 1993 addressed to Vo' a~d the Co~o~ H~th Au/chorltV Approval (fi.A.A.) i66,,ed bV the tJ~clpa~t of A~chorage (U.O.A.) on 10/12/95 the rederenc~ prop~t~.t (copZ~6 a~t~ched) A6 required b~ the Co~tLt~o~ H.A.A. ~e ~ue been mo~C~orlng g~o~nd ROAD DESIG~ 1121/94 4/29/94 12.8 5/10/94 14.0 feet X reg~ct ~o ~{orm ~o~ tJ~t ba~ed upon g~oand mate~ mo~ng 4/~9/94 a~ 5/10/94 the ~nB abao~p~on ~ ~ ~ non~mp~nce ~nce r~ b~e~ gro~ ~ a~ the ab~orp~o~ H.A.A.. SOILTEST PERCOLATION TEST the ~ ~ ~ be ~z~ ~or ~e ~ep~c up, de, p~{o~ ~o~ ~g~de The ~mbZn~ ~6~ {o~ ~ e{~o~ ~ be ~1230.00. A~ ad~o~ ~ee o~ ~50.00 ~ be ~ged ~ ~e ~e ~e ~ ~u~on ~o~ ~ p~do~. ACtu~Z blds for the upgrade of the 6¢pt~c 6V6tem can be obtaJ~ed after the d~6lgn Z6 completed. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER, ALASKA 99577 LE°ALEAGLE RIVER VALLEY RANCHETTES, LOT 25A STRUCTURES, EASEMENTS, OR ENCROACHMENTS TO v[mrY EASEUENTS, ~[eUmEO SEPARATION DISTANCES, AND PROPER~ LINES PRIOR TO co,sT,uCnO,. , DRAWNJ. ANDERSON DESIGN CRITERIA: $ DDRM = 450 GPD SOILS = 0.6 GPD/SQ.FT. 450/0.6 = 750 SO.F'r. REQ'D TRENCHES: 8' DEEP 4' EFFECTIVE 2.5' WIDE (MSt:' 2@50' & 1{}34' LONG) TWENTY GRAND ROAD NOTE: PROPERTY SERVED BY A PUBLIC WATER SYSTEM. EX]STING 1000 GAL. 3 BDRM SEPTIC TANK ~ HOUSE (INSTA[T.ED 10/5/92) ~ FCO/( I~ ~ 4 ;/PROP. TRENCHES x ~,~ow I~-,~ CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION WORK. A~.L PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATION. CLIENT Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST 10 - I ." WAS GROUNDWATER ENCOUNTERED? 11 - r¢ s ~ / L ;K. IF YES, AT WHAT O 12- ¢ . DEPTH? P E 13 - .. I*o~iWing? / ~-~ D~t~ Readin9 Date Gross Net Time Time N SITE PLAN De~th to Net Water Drop 19- 20- PERCOLATION RATE ~,O (msnutes/mch) PERC HOLE DIAMETER ~ .- TEST RUN BETWEEN ~' ~ FT ~ FT COMMENTS ~ ~' ~ // - 170~ Eagle RIv~ L~ R~ PERFORMED BY: E~Ri.=,,AI.sk."5// ~~R~IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF~ O~HIS DATE~AT~ 72~ (R~, 4/~) I~-~: Eagle River Valley Ranchettes: Lot 25A The scope of this project includes the installation of three leachfield trenches to serve the three bedroc~ residence located on the referenced property. The existing trench and crib are to be abandoned in place. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wast.water Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Se Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. e Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. e A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Page Two Eagle River Valley Ranchettes: Lot 25A June 06, 1994 Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 1. MAa~m~IAL SPEcifICATIONS: Any septic tank proposed for installation must be Municipally approved septic tank manufacturer. The following pipe materials are approved for use installations in the Municipality of Anchorage: constructed by a in septic system Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (P¥C) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam~I or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the t200 sieve. Page Three Eagle River Valley Ranchettes; Lot 25A June 06, 1994 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Typically there will be a minimum of three (3) inspections required during the installation of the wast,water disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & $ Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage Page J of~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report .ame~A~ ~. ~~ Wastewater System: D New ~ Upgrade (~.~~_~ JNo. o~ooms: O Deep Trench ~ Shallow Trench OBed O~ DOther Classd,cahon IPnvate. A.B.C): / Total Depth: I Cased To: Total absorption area: / Pi~ material: Y,eld: GPM I Pump Se, ,,: Fl I~smg He,gh, A~ Groun~Fi. TANK SEPARATION DISTANCES ~epti~ D Holding a S.T.E.P. Manufacturer: apacity in gallons: From We, Surface Water LOt Line Fo.ndation Cu~ain Remarks: LIFT STATION Size in gallons: J Manufacturer: "Pump on" lev~evel M: I High water alarm t Pump M.~,~odel I Electrical Inspections perlormed by: BENCH MARK Locabor~ and Descfipbon' Inspections performed by: ~ m.r, nl.k..'' Dates: 1st . ~ % No~ 8215/ ~" ~:'.. . Department of Health a~ Human~ces approval ¢¢ Reviewed and approved by C~ Date: / Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: I~:~r"'~ · PID No.: 72-013 A (Rev g/~l) MOA 2~ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L# STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920323 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:LANGE JAMES B & OWNER ADDRESS:lB610 TWENTY GRAND RD EAGLE RIVER, ALASKA 99577 DATE ISSUED: 10/01/92 EXPIRATION DATE: 10/01/93 PARCEL ID:05022317 LEGAL DESCRIPTION:'EAGLE RIVER VALLEY RANCHETTES LT 25A LOT SIZE: 17955 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: SEWEREWATER MAINEXTENSIONS September 28, 1992 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694.2979 FAX 694.1211 SEWER & WATER INSPECTION REFERENCE: Eagle River Valley Ranchettes Subdivision, Lot 25A WELt. INSPECTION S Ft.OW TEST SITE PO, NS ROAD DESIGN SOtL TEST Request you issue a permit to replace the septic tank serving the 3 bedroom home on the above referenced property. In excavation of the septic tank to repair a clog in the sewer pipe, the tank was found to be of poor integrity with holes throughout. If you require additional information for your review or have any questions, please contact us. Sincerely, Roger J. S~afer, P.E. RJS/LSU/lsu PERCOLATION TEST STRUCT%JRAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAt. SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 From Bu/Tding b Unknown. House Conslructed W#h A Poured Concrele SNb As Opposed To i Crowl $poce. HOUSE LoT 25A PROPO3ED NEW I000 G,4L SEPTIC T,~JVK EXIST. TREI~ IO'UT/L. ESMT iATER KEY BOX LOT 25C ~...EXIST. CRIB TO BE ,~U~,Jt~D - ENCROACHING W,4TER LINE I I PROPERTY SERVED BY A COMMUNITY WATER SYSTEM THERE ARE NO WELLS WITHIN 200' OF PROPOSED SEP TIC ^~ su..u~s ~2~ LOT 26A LEGAL DESCRIPTION =AT,ON DISTANCE 'l MUN~C'PAL'TV Or ANC.ORACE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Crib depth Building foundation Driller Sewer line Dwelling Material Type of crib Crib diameter DISTANCE TO: Building foundation DISTANCE TO: Width Material Trench widt h~ ~inches NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. ~YO 0 q' '7 0 PERMII NO. Total ef fecti~ absorption area Nearest lot line D~stance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS SO~L TEST RATING INSTALLER RK$ ~ APPROVED DATE LEGAL L~,5 ,q PERMIT NO. DEPBRTMENT O~HE~LTH ' 825 264-472~ {) ~ , LOCRTZON 2~-GRRND ROAD LEGAL T~LOT 25R E.~.~,~.V~L~EY..RRNCHETTE"-~ LOT 5[ZE 2~eee SQUARE FEET TYPE OF 50IL RBSORPTZON SYSTEM Z~: TRENCH MAXIMUM HUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= l~G THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= :1.2 LE~-.IGTH= 42 G F~R","E L DEPTH= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TREHCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES, THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REi~U I RED --qEPT I C TRI%i~( $ I ZE= ieee GRLLOt-,I$ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE IHSTRLLRTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER .OF RESIDENCES THAT THE WELL WILL SERVE. ------ Tt--I 0 '~ ~' ~' I I%I_'L:;PECT I Ot~l$ ARE REQ..U I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT HILL BE SUBJECT TO PROSECUTION. MIMIMUM DISTANCE BETWEEH R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS' 100 FEET FOR R PRIVATE WELL OR i50 TO ~00 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC HELL. MINIMUH DISTANCE FROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY, SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER IHSTRLLRTION. PEAr'1 1' T E×P I I;~E$ DECEI'IBEE 3'1.. :1.3S0 I CERTIFY THAT ~.: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. .~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMEHT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: ...................... ~ ............ ~ .... APPLICANT TONY LRNG ISSUED BY .............................. DATE_ :_SC_ .... V4. 0 r-II_lpg4 I I3 I PAL I T'T' . I)F:' ANCHORAGE DEPRP~THENT~'~ HEALTH FtND'ENVI~OtlH~t~TR~ROTECTION 825 ' _' ~TPEET, RtJCHORRGE, AK. t JO1 264-4720 LOT SIZE~ Ii ~)~0 SOURRE FEET ~,lA;<irlur,1 r4LIr.~BER OF BEDROOMS =~- S01L RATING <5:,0 FT/BR)= /?/z:~ THE REQUIRED SIZE OF THE SOIL ):iBSORPTIOti SYSTEr~ IS: C. EF'T,-4= /,~_... LE~.h3TH= /7/<~ GRR',...'EL DEPTH=7 lHE LE,,GTH DIr'iEr4SIO, IS THE LENGTH (IN FEET) OF THE TPEr,CH OR THE DEPTH 0F A TRENCH 0R PIT Z~ THE ~I~TRNCE BET.EEN THE SURFACE OF THE OROUHD AND THE BOTTOH OF THE EXCAVAT,Or, (Itl FEET). TI.JCm ~. 2 ,~ I 1'-4--'5PECT I 0 I'-,t'__; FIRE REQLI ! RED- BACKFILLING OF ANY SYSTEH HITHOLIT FIHAL INSPECTION AND APPROVAL BY THIS DEPRRTHEtlT HILL BE SUBJECT TO PPOSECUTION. HINIMUri DISTANCE BETWEEN R WELL AND ANY O/J-SITE SEHRGE DISPOSAL SYSTEM IS 1~0 FEET FOR Fi PRIVATE HELL OF.' 150 TO 2~30 FEET FROr. I R PUBLIC HELL [~EPEtI[',ING UPOH THE TYPE OF PUBLIC HELL HINIMUH [,ISTRNCE FROH R PRIVATE HELL TO R PRIVATE SEI.IER LINE I~ 25 FEET TO A COHHUtIITY ~EHER LINE IS 75 FEET. WELL LOGS ARE REOUZRED AND MUST BE PETURNED TO THE [:,EPRRTHENT I,IITHItl 30 [~RY5 OF THE HELL COr~F'LET[ON. OTHER REOU[PEHENT~ MAY RPPLV. 5PEC~F[CRT[OtlS AND CONSTRUCTION D~RG~RH~ ARE AVAILABLE TO JNSUPE PROPER ]N~TRLLRT[ON PERr-'I ! T E×P ! RES DEm-~.EPIBER ~:..--I .. 198p~--3 I CERTIFY THAT 1: I APl FAHILIRR WITH THE REOUIREHENTS FOR ON-SITE SEWERS AND HELLS RS SET FORTH DY THE HLINICIPALITY OF RNCHOF~RGE, 2: [ HILL IN~TRLL' THE ~Y~TEH IH ACCORDANCE HITH THE ~: I UtlDEPSTRt~[~ THAT THE ON-~[TE ~EI,JER ~MSTEH HAY REOUI~;E ENLRRGEHEtIT ZF THE PESIDENCE I~ F:E~ODELED TO INCLLmDE HOPE THRtl 3 E'EDROOH~. .... ........... RPPL I CA/IT ~ .-* [] SOILS LDG MUNICIPALITY OF ANCHORAGE .. DEPARTMENT OF tlE/~i.'lrll AND ENVIRONMENTAl. PROTECTION Pouch ~-,~50, Anchora~e,.~Alaska 9950:2 276-222~ .. PERCOLATION TEST SOILS LOG - PERCOLATION TEST 13- 14- J 15-- 17-* 18- 19- 20- '~ %. *" ~ PERCOLATION RATE · L'~OF[S~C~~ TEST RUN BE~/EEN COMMENTS 72 003 Time Time Depth to Net Water Drop /~/'~ ---- 2_I ~Z" ~. t/ ', /7.. GRI' -', ANCHORAGE AREA BO u'"'H Department of Envlronmenta Ou lity 3330 C Street Anchorage. Alaska 99503 NAM E /'//~/' ! 7~,', LOCATION ~'' j~3, INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ~'.,t ~... MAILING ADDRESS PHONE LEGAL DESCRIPTION "~'~,~ .~'-/ SEPTIC TANK: DISTANCE FROM NUMBER OF MANUFACTURER *-~. '~ MATERIAL ?~'" / COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY /~'~'~'~;' GALLONS. SEEPAGE PIT= NUMBER OF PITS ~/ DIAMETER OR WIDTH LINING MATERIAL ~/AI(>.~ CRIB SIZE: DIAMETER BUILDING FOUNDATION ~' , NEAREST LOT LINE.,A LENGTH '~"i,'' DEPTH DEPTH DISTANCE FROM: WELL~---'~''/t ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '-'-'-~'" SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ~-~,~ ~ ~, BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST NEAREST LOT LINE SEWER LINE OTHER SOURCES DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK -- SYSTEM DISTANCES: iNSTALLED BY: '///f~;' / ~''Y E'~C' PiPE MATERIAL.' /'~// LOT SLOPE= REMARKS: Form No. DIAGRAM OF SYSTEM /%~o ~',~r C.~,.- ,. ,-~."/~' ' -,~.~ I W~/t ~*~ I '. Municipality of Anchot'age Development Servlci ; D6pdHment Building Safely Divislon . On-Site Water and Wastewaler Program ' 4700 South Brag.~w St. ~ P.O. Box 196650 Anchorage, AK 995tg-6650 ~O w,,wv.cl.anchorage.ek. Us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-223-17 HAA// .;,,~:.,,. Expiration Date:. t. GENER~L~INFORMATION : .'.? .. -.. , ?~ Coml~l~te'.l~galdescripli0n. T.ot 25A; Eagle River Valley RanchettesS/D Locabon (mteaddressord~.recllons) 18610 Twenty Grand Rd,, Eagle River Day phone 552-4422 Day phone C,.drrent Propertyowne*r(s) Kezth Muschinske ..... " Same 'M_ailing address"- AK 99577 Mailing address Real Estate Agen! Mailing Address Unless olherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 Day phone 3. TYPE OF WATER SUPPLY: Individual Well Individual Wa[er Storage Community Class ~. Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Communily On-site [] Public Sewer [] The Municipality of Anchorage Developmenl Services Department (DSD) Issues Certificates of Health Authorily Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer regislered In [he State of Alaska. Certifcates et Health Authority Approval are requtred for Ihe Iransfer of title (except between spouses) tar properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificales of HeaIlh Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new waler sample results less then 30 days old. (Certificates may be reissued for a period el up to one year with valid water samples.) Certific'~es are valid for one year lor properties served by Class A or 13 wells or a public water system. The Municipalily of Anchorage is not responsible for errors or omissions in the prot'essional engineer's work. 4. STATEMENT OF INSPECTION bY E~GINEER As cedi~ed by my seal affixed hereto and as of the validation dale shown below, I verify that my Invesllga{ion, based on procedures outlined In the Health Au{horfly ,Approval Guidelines for Ihis application, shows Ihat the on-site water supply end/or waslewater disposal Sy{terrJ Is(are) {are, funcUonal and adequate for the number of bedrooms and lype of structure Indicated herein. I [urther Verify {ha{ based On the Information obtained from Ihe Municip.ality of Anchorage files and from my Investigation and Inspection, the on-site water supply end/or wastewater.disposal system Is(are) In compliance ik, ith all applicable Municipal and S~ate codes, ordinances, and regulations In effect at the time o[ Installation. '~-"t: ~'. Phone 6(,:,)4-20 9'-' Name of Firm S & S Engineering Address17034 N. Ea~le River Lp. Rd.: Engineer's Printed Name Robert: C. Co,/an 5. DSD SIGNATURE . ~ Approved for ~ Disapproved. Conditional approval for bedrooms. Date ^ . .'..,.,( ,,:....... bedrooms, with the following slipulations: Additional Comments Attachments: HAA Checklist Septic Sys{em Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Cedificate Date: M. nlcipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bmgaw St. P.O, Box 196650 Anchorage, AK 99519-6650 w~w.cLenchorage.ak.us (9O?) 343-7~04 HEALTH AUTHORITY APPROVAL CHECKLIST Well ~e If ~ B, ~ C p~e~ Dine ~ple~ ~l~ 1~ d~ [ in- Da~ ~ t~t S~fic ~ ~ ~ ff. Well p~u~on ~ g.p.m. WA~R ~P~ ~SULTS: Colff~ ~~ie~l~ mi. Ni~ ~. ~ ~lonie~l~ mi. Date ~ sample: ~1~ ~: B. SE~OLDING T~K DATA ~1 F/~ ~ ~ ~ ~/~ Tank Ty~re~ .... .~rl~, . / ~ Date ~s~ll~ T~k s~ '~ ~ · Num~ of ~en~ ~ ~ ~/N) Fou~a~on ~ ~) ~ Dep~sion ~r ~k (Y~) ~ High ~r ala~ (Y/N) . ....... C. ~SO~ON FIE~ ~TA' Len~ ~''' fl. ~ ~ fl. Grav~bet~pipe ~ Date of adequa~ t~t ~ ~u~ail) For ~ b~r~ms Fluld dep~ ~ abs~ field be~ ~t ~ Wa~r add~ gal N~ in, E~ps~ Ti~: ~ ~n. F~ ~ : ~. ~so~n rate >= / g.p.d. ~y mjuve~fion ~ ~st 12 ~ & ~pe); T If yes, ~ate Well Log (Y/N) / Casing height (above~'obnd) V / g.p.m. / D. LIFT b'rATION Date installed 'Pump on" level at Datum Size in gallons 'Pump off level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tenk/tift ,teflon on lot ,//' On adjacent lots Absorption field on lot // On adjacent lots / Public sewer main / Public sewer manhole/clelleut Sewer/septic senate line / Holding tank SEPARATION DISTANCES FROM SEPTIC/H...0M3~'TANK ON LOT TO; Building foundation ~ /~- Property line ~' ~-- Absorption field Water main /C~ ~ "~ Water service line //O I Sun~acewater /LO(~) /~- WelDs on adjacent lots ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~ ~' Building foundation / C~ ~-/- Water main / / .~ t/ OO ! '/- Driveway, paddng/vehicie storage Water Service line / C~ Surface water cu. in d, in J w.,s o..djacent lets F. COMMENTS review of Mun~p~ m~a that ~e ~n~an~ ~ M~ H~ ~ellnes HAA Fee $,~ "/5~', ~ Date of Payment Receipt Number (Rev. 12/00) ~'~$~' ) Waiver Fee $ Date of Payment Receipt Number Parcel I.D. if · ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CER~'IFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 050-223-17 ~ NAA# GENERAL INFORMATION Complete legal description '-[,ot 25A, Eagle River 1/'alley Ranchettes Location (site address or directions) 18610 Twenty Grand Road Property owner ' James Taylor Day phone 696-8855 Mailing address 18610 Twent'.¥ Grand Road, Eagle River, Ak 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ', TYPE OF WATER SUPPLy: Individual well Community well Y~ ~ Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5.' STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & S ENGINEERING Phone ~ q ~/ -'3-~' ?q l/u3.~ l-agJe K~ver i. oop Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature .~,~Z/ ~v'* Date'7/~'/~ Se DHHS SIGNATURE ~ Approved for "'r HP, E E. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Mtinicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. · "~ Municipality of Anchorage DEPARTMENT OF HEALTH .& HUMAN SERVICES Environmental Services Division dUE 08 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907~,~e434~4~uT~= Health Authority Approval Checklist A. WELL DATA Well type ~ J,I/,~/'~"~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary see (Y/N) Date of test Stefic water level Well production WATER SAMPLE R~~ Coliform Date of ~ B. SEPTIC/NOt. DING TANK DATA Date completed Cased to FROM WELL LOG ~ g.p.m. Casing he~und) Wi~J~fly protected (Y/N) AT INSPECTION Nitrate Other bacteria Ce Tanksize /~)¢~C~ Number of Compmtmente Depmseion (Y/~ /V'6 High water alarm (Y/N) Pumper ~/;~'~ )/ g.p.m. Length /OP ' Width Z /~'/r Gravel thickness below pipe Effective aJ:~o~flon area R~ ~ Monitoring Tube present ~lIN) F~-$ Depression over field (Y~) ,/~,/0 Ruid depth in absorption field before test (in.); / Immediately after'~'gaJ, water added (in.): Fluiddepth :~"~// "~(ins)Mlnutes later: ~,~ = g.p.d. Pemxiddtmatment(past12months)(Y/N) ,~/0~/6.- k',ee~,,"lfyas, gJvedate ?2-o26 (Rev. Soil rating .p(!~.d ~ or Iff/bdrm) ~e~ System type T,~v'¢/'] UFT STATION Date installed Manhole/Access (Y/N) High water aJarm level Cycles tested ~ "Pump off" level at* E. SEPARATION DISTANCES F. SEPARATION DISTANCES FROM WELL ON LOT TO: . Septi cld,ng tank on-' ' O. adjacent / Absorption field on lot ~ Public sewer main ~bltc sewer manhole/cleanout Sewer/septic ~[[~I~'~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation S/'~' Property line /O/'/- Absorption field ~'/"/- Water rnaJn/service llne /Q / Surlace water/drainage /(~/'/''' Wells on adjacent lots /V/,~. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Properly line /O / Building foundation /~)/'/' Water main/service line /'42 Surlace water Curtain drain Driveway, parking/vehicle storage area on adjacent lots /V/~R Wells ENGINEER'S CERTIFICATION ~ ~'"~'~ !~1~ I certify that I have deten~ined thru field inspections and review of Municipal reco~ef~l'gE~ [~i[~s am in conformance wiJh ~O~41-1~A guid~ellnes in effect on this date. _~.~ // ~ '~,'z'~ ;;:: :':::':::i;~,'-~_?~ HAA Fee $ '--"'~' / ~ Date of Payment ~/~'~' Receipt Number 0'4Z'~2'~',~4/.'7 ~/') Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 'MUNICIPALITY OF ANCHORAGE /'~ DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage,Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY . APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # /"~ ("~ ~ ,"~ ~ ,-~ ' ~ '~ HAA# GENERAL INFORMATION Complete legal description Lot 25A: Eaqle River Valley Ranchettes Location (site address or directions) Property owner Mailing address Lending agency Mailing address 18610 Twenty Grand Road James Lanqe Day phone c/o Greatland Realty 11411 ~1~ ~lpnn R~y.~ Pmgl~ R{v~. AK 99577 Agent Kay Addrisi/Greatland Realty Address 11411 Old Glenn Hwy., Eaqle River, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well Community well Public water Xxx Day phone Day phone 99577 NOTE: 694-9125 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance .with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Phone /"~-'~ ~/"~-z'~ ~/~' Name of Firm Address 17034 Eagle D~-IHS_ SIGNATURE /"'~ Approved for bedrooms. o Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date Installed IO - ~-~ ~ Date of pumping Municipality of Anchorage ,~ Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: . Parcel I.D. ~ ~-'~/'D'~'~ ~'~ I A. Well Data Well type ~,~'-"11'~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N)l'J//::~· Date completed Drip/ Total depth Cased to C.,~g height Sanitary seal (Y/N) Wires properly pretend ~/N) FROM WELL LOG A~/~N*SPECTION Date of test * . - ~ - Static water level E ¢ E I V E D SEPARATION DISTANCES FROM WELL TO.~,, ' - Septic/holding tank on lot '~43 ~"~' ; On adjacent lots I'~//~' Absorption field on lot ~,.~) L.{..-- ; On adjacent lots t*~1/~ Public sewer main Public sewer~nhole/cleanout / Sewer service line Petrole~ tank Nitrate~ Other bacteria Collected by: Tank size I O~ ~ Compartments Foundation cleanou~)y Depression (Y~ ~ Alarm tested (Y/N) t',--,1/ C:~ . ~.~ .~' '~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Foundation Water main/service line Well(s) on lot ~'~ ~."~ On adjacent lots t',~/~:~ To property line "~/'"~ / Absorption field Surface water/drainage ~ C~4~ t ~ CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manuf~r Size in gallons M53nhSle/Access (Y/N) Vent (Y/N) 'Pump on' level at / 'Pump off' Level at High water alarm level / Cycles tested Meets MOA electrical codes (Y/N) / SEPARATION DISTANCE FRO~FT STATION TO: on lot / On adjacent lots Sudace water Well D. ABSORPTION FIELD DATA Date installed U/~.~/~'z:~'' Soil rating (GPD/Ft~) ~>. ~ System type -T'"~.-~ ~_..{"~- L~ngth . [~ I Width ~/--'~--~ Gravel thickness Total depth ~, I Total absorption area 8424:2 ~E~ Cleanout presen ~.~) y Depression over field (Y~). /~ Date of adequacy test ~'~/¢~" Results (pass/fail) I,-J~'l~ '~.¢~1'~'r'~ for ~ Bedrooms Water level in absorption field before test J'-)/~ After test ~--~/~ Peroxide treatment (past 12 months) (yQ ~ If yes, give datef J/ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I'--)/.tz~ On adjacent lots '~:2 ! ..p.- Property line I ~ / To building foundation J ~.) / To existing or abandoned system on lot I~.)' Jr" On adjacent lots '~ ~ ~ Cutbank I~ c~ ~ ~: Water main/sewice line I~ z Sudace water [~'~:::) ~ 4,-- Driveway, parking/vehicle storage area ~-~ (-~' +---- Curtain drain ~.~ ~ E. ENGINEER'S CERTIRCATION I certify that I have checked, ve#fied, ~c_.~¢32~m~d to all MOA and HAA guidelines in eff~_t~.~or4.~a, te of this inspection. Signature / - HAA Fee $ Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number 72-026 (3~93)' Back June 28, 1994 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMANSERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ROBERT SHAFER, P.E. ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 RECEIVf:-D JUN 2 9 199 Municipality o! Anchorage Dept. Hentth &. Human Se~lces REFERENCE: Eagle River Valley Ranchettes; Lot 25A A Conditional Health Authority Approval (HAA) was issued on October 12, 1993 for the referenced property. All work required for the Conditional HAA has been completed. Attached is the On-Site Wastewater Disposal System and/or Well Inspection Report for your approval. We request you issue a Final Health Authority Approval for the referenced property. If you have any questions or require any additional information, please contact us. ~E PtANS ROaD DESigN SO6. TEST /jk PERCOCAT~N TEST 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~c~/_.~(~ -Ct~- ~-/~,-ctL[ 'HAA# ~"~Ot'Z~tr)t.~ GENERAL INFORMATION Complete legal description Lot 25A; EAgle'Rlue~r Valleq Rane. he~e~ e Location (site address or directions) Property owner Mailing address ~ Lending agency Mailing address 18610 Tu~ent~ 'Granc[ Rd. Eaqle River, AK 99571 Day phone Eagle Riue¢. AK 99577 Day phone Agent Kc~V Addr~.6Z/GREATLAI~ REALTY Address 11411 Old Glcn~ Hwy. Eagle. RZu~¢ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: $ ~, TYPE OF WATER SUPPLY: Individual well Community well Public water XY, X NOTE: Day phone 694-9125 Ala. z, ~z 99517 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site XYJ( Holding tank Community on-site Public sewer If community wastewater system, proVide written confirmation from State ADEC attesting to the legality and status of system. Se . Name of Firm NEERING ~ -'-'" S&$ ENGI Address ~ 7034 Eagle River Loop · - . . Eagle River, Ala~a .99577 '/ engineers s~gnature ' ' / /./--t STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my inves.t~ation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Phone F, F4'z-?7 bedrooms. DHHS SIGNATURE ~ Approved for ~ DisapprOved. __~ Conditional approval for ~)' bedrooms, with the following stipulations: Additional Comments ~o/~ .,~,~-,~'-~ ~' ,P~'~/,',~ ,-~,.;~z~co The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the pro!essional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~'Z'~J~, ~-~.~i ~9_~ ~.. Pamel I.D. A. Well Data Well type ~J~'~ /~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level ~ ~ '~ ~ ~ g.p.m, g.pr'~ ~ If A, B, or C, attach ADEC letter, ADEC water system number Date completed Driller - Cased to Casing height ~ Wires prope~y pr~ ~o~ FRO. WELLLOG Pump level! SEPARATION DISTANCES FROM WELL TO: SepticJholding tank on lot 'Z..o ,. t ~' ; On adjacent lots Absorption field on lot "/~,'"'~ '~' ; On adjacent lots Public sewer main Public sewer manhole~ Sewer service line Petroleum tan~ WATER SAMPLE RESULTS: ~ Coliform ~ Nitrate Other bacteria ~ Collected by: B. SEPTIC/HOLDING TANK DATA Date Installed Cleanouts ~'N ) V High water alarm (Y.~) Date of pumping Tank size I, ,c>o ~. Compartments '?-- Foundation cleanout (~/N) y Depression ~¥/~ J Ala~ tested ~) ~ ~ ~ ~ Pumper -,~_~ ~ ' ~ ~o ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: '"7,--o e. ~' 4.-- On adjacent lots ~[' [ ~- Absorption field I ~ Well(s) on lot To property line '~ ,3,~ Sudace water/drainage Foundation Water main/service line · 2~2s (3~3). Fret CONTINUED ON BACK PAGE C. UFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) 'Pump on' level at '~at High water alarm level ~d Meets MOA electrical codes (Y/N) SEP~I~TION TO: Wett~n lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed Length ~ '~ t Width Total absorption area L, ol. ~,~.c. Soil rating (GPD/FF) \~ b, ~ I'~z.-. System type '"~ Gravel thickness '~ ~ Total depth Cleanout present ~'/N) '~ Depression over field (Y~ Date of adequacy test ~. ~ .- '7.--~'5 Results {~,'fail) P.~"~ for 3, Bedrooms Water level in absorption field before test I'''~(.~-~'~ After test "7 P~_roxide treatment (past 12 months) (YJ~ ~ d' ,.\ r~., V- ~,-3 ~ If yes, give date SI~'pAp~TioN DISTANCE-I~ROM'ABSORPTION FIELD TO: Well on lot ~ ... t ~ On adjacent lots ~ / ~. To building foundation On adjacent lots .--z..,..~ ~,~' Property line To existing or abandoned system on lot Cutbank ,.-[ I.~..- Water main/sen/ice line Driveway, parking/vehicle storage area '~'-o Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the.d.~te of this inspection. ~ / -.~., l."~t' .~t.~"~' ~.., '. ,,d" / S~gnature .... ~ngmeers r~ame_ . - -~. ~,~l~e. 294 , - ~,./'~~ .~.~;~; ~" Date C ~-- / ~/"--~ HAAFee$ r.,'~O~ r ~ WaiverFee$ Date of Payment ~/O --~.-,--~'.,~ Date of Payment Receipt Number ~. ,-~,,'~, ,,*~ ~ /-~,~//~ Receipt Number 72-(~6 (3~93)° Back G~TER ANCHORAGE AREA BOROUGH Department of Envirornuentel Ouattt.v 3500 Tudor Road, Anchorage, Alaska 99.507 279-$685 Date Received Time of Inspection Date of Inspection REQUEST FOq. APPRO~IAL OF IIEIVIDUAL SI~ER & WATI/R FACILITIES F.H.& Phone: Phone, Lot 25A, Eagle Rtver Valley Ranchettes Stngle gmtly Owelltnq ~. Depth D. Bacterta] Analysts 1. Aoproval Requested 6y: Cou~Jneau & Reeves ^~ss~ BOx 763 Eagle Rtver AK 99577 2. Pro~ert¥ Owner: 3. Legal Description: a. LocatLon: 5. Type of Facility to be Inspected: Number of ~adroems: Three (3) 6. Well Data: ^. Ty~e Oan Bell Utilities C. Const~uction 7. 5ewaqe Ots~osal.Syatsmg A. Installed 7-5-73 8. Instal let Ham11ton C. Septic Tank: 1. Size lO00Gals 2. Manufacturer Stack Steel D. Seepage Pit: 1. Size 2. Materiel COncrete Rtnqs E. Disposal Field: Total Length of Lines Distances: Well To~ Septic Tank , Nearest Lot Line August 28, 1973 333-5767 .A. , Absorption Area , Sewer Lines , Other Contamination B. Foundation to Septic Tank 10' '*) Absorption At~a 35' C. Absorption Area to Nearest Lot Line Ap.oroval Vmlid for One Year Anchorage Arem Borouoh, Department of Bnvirorm, enta] Quality DIAGRAM OF ! c~.~tif,/ 2hat the information contained in thte request for appreval to Be a true and mccur~e represent~tto~ of the subject sewer and wnter facilities located mt,' Signed Date